Thought Leaders

Developing standards for unstructured documents

Creating a strategy for managing unstructured documents does not have to be an onerous task.

It’s estimated that 60 percent of healthcare data resides outside of health information systems in unstructured documents – documents that contain the full narrative of a patient’s history – rendering them unsearchable and un-actionable to care providers and the information systems they rely upon. This is not spread across the population, but instead applies to each individual patient with his or her own unique medical history. How comfortable are you with the idea that a physician may only have access to half of your medical information?

The federal government has now weighed in to begin imposing requirements for meaningful use and interoperability of healthcare systems. To meet these requirements, the healthcare industry as a whole has had to rally around the cause, developing new industry standards in response to make certain that systems can communicate with one another as the shift occurs. With the continuum of care extending beyond both geographical boundaries and areas of specialty care, access to this information needs to be universally available, even across different systems.

The first step that every member of the healthcare community should take to address this issue – from the CIO in a large hospital system to a single doctor working in private practice – is to participate in the creation of a strategy for adoption that includes all of the hardware, software and people that will be involved, and to establish a realistic timeline for successful implementation. According to the Office of the National Coordinator (ONC), the branch of the federal government charged with overseeing the restructuring of our healthcare system, provider organizations should already have entered into Stage 1 of meeting meaningful-use requirements. This first and most elementary stage of what has been termed the HITECH Act requires only that doctors and hospitals purchase and begin using electronic medical record systems. For Stage 2, which begins in January 2014, the requirements become more stringent and revolve heavily around interoperability, or the communication of healthcare data across systems.

This task would be challenging enough were it not for the extraordinary volume of unstructured data that exists. Introducing this information, whether it originates on paper or in electronic form such as a Word document, presents an enormous challenge. While scanning these documents does take a major step toward moving away from the cost and inefficiency of paper-based systems, there is a hidden danger of populating health information systems with useless or un-actionable data.

The term “meaningful use” was coined by the ONC for precisely this reason. But as the definition of this term has been bandied about by the various stakeholders involved, it is the healthcare providers – doctors, nurses and practitioners – who ought to know what fits best into their work environments.

There is a concept among technology analysts known as “consumerization,” which suggests that, as the general public becomes more comfortable with the technology they use in their homes, they come to expect the same simplicity and satisfaction derived from these consumer-oriented technologies to migrate into the work environment. Much like the iPad has begun to work its way into offices around the globe, other technologies are expected to follow a similar path; as they do, our expectation of the way they fit into daily life will precipitate a meaningful use of its own.

If technology is disruptive, it can cause doctors to see fewer patients, create billing headaches and even impact the quality of care. Only those devices that live up to the vision of better, simpler, faster will survive. For example, as computer hardware becomes more and more mobile, devices that utilize a touch-screen in place of a mouse will become desirable. And as the shift in data hosting moves into the cloud and away from servers hosted on premises, devices that are designed to make use of the Internet as their network connection will displace those connected by Ethernet cables.

Creating a strategy for managing unstructured documents does not have to be an onerous task. In fact, there are products for scanning in unstructured documents available today that will make introducing this information into the system in a meaningful way both quick and easy. Costs have come down too, with basic systems available that do not require a server, sophisticated enterprise software or even a workstation. Instead, look for network-attached capture devices that are designed to address the specific needs of unstructured patient documents and apply technology based upon industry standards to address the problem.

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